膀胱自扩大术治疗高反射性神经源性膀胱10例体会

2002年8月～2005年4月，我们采用膀胱自扩大术治疗10例高反射性神经源性膀胱患者，疗效满意。现报告如下。     

外源性P16基因导入对人膀胱癌细胞增殖及凋亡的影响

目的：将外源性P16基因导入该基因纯合性缺失的人膀胱癌细胞系，观察对肿瘤细胞增殖活性及凋亡的影响。方法：构建P16逆转录病毒表达载体，转染膀胱癌细胞系，应用Northern杂交及免疫细胞化学检测外源性P16基因的表达；流式细胞仪检测细胞周期，原位细胞凋亡检测及透射电镜观察细胞凋亡。结果：转染外源P16基因的肿瘤生长速率明显降低，Ki67标记指数下降，大多数细胞被抑制在G0和G1期，同时发现凋亡细胞的存在。结论：外源性P16基因导入不仅抑制膀胱癌细胞的增殖，且可诱导其凋亡。     

功能性区域颈淋巴结清扫术对多发性颈淋巴结核核患者颈部功能及预后的影响

目的探讨功能性区域颈淋巴结清扫术对多发性颈淋巴结结核患者颈部功能及预后的影响。方法将81例多发性颈淋巴结结核患者随机分为分为2组。对照组40例行颈部结核病灶清除术,观察组41例行功能性区域颈淋巴结清扫术,比较2组颈部功能情况、住院时间、切口愈合时间与愈合良好率及复发率。结果观察组颈部功能正常率及切口愈合良好率高于对照组,复发率低于对照组,住院时间、切口愈合时间均明显短于对照组,差异均有统计学意义(P0.05)。结论功能性区域颈淋巴结清扫术治疗多发性颈淋巴结结核,术野清晰,彻底清除病灶同时对重要血管与神经进行保护,利于术后颈部功能恢复与切口良好愈合、复发率低、预后佳、效果满意。     

Expression of miRNA-630 in bladder urothelial carcinoma and its clinical significance

Many studies informed that microRNAs (miRNAs) could function as diagnostic and prognostic indicators in several cancers. The aims of this study were to explore the expression of miR-630 in bladder urothelial carcinoma and its clinical significance for the evaluation of cancer prognosis. A total of 116 patients with bladder urothelial carcinoma were obtained in this retrospective study between May, 2012 and Sep. 2015. Quantitative real-time PCR (qRT-PCR) was conducted to evaluate the expression level of miR-630. The chi-square test was used to examine the associations between miR-630 expression and the clinicopathological features. The Kaplan-Meier method was conducted to explore the survival status of urothelial carcinoma patients. The log-rank test was used to analyze differences in survival rate. The results showed an obvious increase in miR-630 expression from normal bladder to bladder urothelial carcinoma (P=0.027). Additionally, patients with higher miR-630 expression had significantly shorter disease-free survival (DFS) (P=0.043) and overall survival (OS) (P=0.038) than those with lower miR-630 expression. Furthermore, multivariate analysis revealed that up-regulation of miR-630 was an independent prognostic factor for both DFS (P=0.042) and OS (P=0.046). It was demonstrated that miR-630 may be a novel and valuable prognostic factor for bladder urothelial carcinoma.     

结节硬化型肾错构瘤的诊治进展

1概述
　　肾错构瘤又称肾血管平滑肌脂肪瘤,是一种良性肿瘤,可单发或多发。根据有无合并结节性硬化症可分为2型：Ⅰ型合并结节性硬化症,常双侧多发,体积较大,增长速度快,较易出现临床症状,发病年龄较小。Ⅱ型较多见约占80豫,不伴结节性硬化症,常为单侧,体积较小,中年女性好发。据文献［1］报道2型肾血管平滑肌脂肪瘤患者肿瘤年平均增长速度分别为20豫、5豫。     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

Fas配体基因在肾细胞癌中的表达及其意义

目的 探讨Ｆａｓ配体（ｒａｓ ｌｉｇａｎｄ,ＦａｓＬ）基因在肾细胞癌中的表达及临床临床。方法 应用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）及免疫组织技术化学分别检测ＦａｓＬ ｍＲＮＡ及蛋白在５１例肾细胞癌中的表达。结果 ５１例肿瘤 ３２例ＦａｓＬ基因阳性表达。其中１、２、３级肿瘤中ＦａｓＬ的阳性表达率分别为２５．０％、６３．６％、８８．２％,１、２、３、４期肿瘤肿瘤中Ｆａｓｌ的阳性表达率分别为３１．６     

植物来源天然小分子化合物防治骨质疏松症的研究进展

摘要：骨质疏松症是一种以骨量减少、骨质量下降和骨微结构退化为特征的全身性骨病,其病因主要是骨代谢障碍,即破骨细胞的过度形成,导致骨吸收增加和成骨形成不足所致。传统中草药等植物来源的天然小分子化合物由于来源丰富、结构多样、不良反应少等特性可作为预防和治疗骨质疏松症的替代药物。本文综述了近年来发现的具有骨保护作用的植物来源的天然小分子化合物的研究进展,以期为预防和治疗骨质疏松药物的开发提供新思路。     

合并神经原性膀胱活动低下非瘫痪脊髓功能障碍患者生命质量评估和尿动力学研究

Objective To investigate the change of quality of life and urodynamics after the enterocystoplasty combined with clean intermittent self-catheterisation (CISC) in nonparalytic spinal cord dysfunction (NSCD) patients with neurogenic underactive bladder by the Medical Outcomes study 36-item short-form general health survey (SF-36). Methods The quality of life of 72 NSCD patients with NUB were measured by SF-36 questionnaire, who had been taken enterocystoplasty combined with CISC or only CISC according to urodynamic results. In total, 58(81% ) patients were successfully followed for one year by SF-36 questionnaire and urodynamic examination, including 30 men (mean age 27±5 year) and 28 women (mean age 26±4 year). The normal volunteers without lower urinary tract symptom were set as control group, including 20 men (mean age 28 ± 4 year) and 20 women (mean age 29±4 year). Results At the follow-up, physical role, vitality and social function of men and women were 55±14 and 45±15, 76±19 and 74±15, 52±19 and 59±13 respectively, significantly higher than those before the treatment (35 ± 10 and 32 ±11, 27 ± 18 and 33 ± 17, 40 ±12 and 34 ±15). The bladder compliance and maximum cystometric capacity were (320 ± 44 ) ml and ( 338 ±50)ml,(55±15)cm H2O and (60±17)cm H2O respectively, also significantly higher than those before the treatment (131±30ml and 140±35ml,5±3 cm H2O and 6±4 cm H2O). However, detrusor leakage point pressures were (6±2)cm H2O and (6±3)cm H2O respectively, significantly lower than those before the treatment (28 ±9 cm H2 O and 25 ± 6 cm H2O). Except for physical function and bodily pain, the all domains of quality of life in both men and women patients were significantly lower than those in control group. Only 17 % of men and 7 % of women believed "their health is better than that one year ago". There was no significant difference in the remission rate between men and women (89% vs 76%) in the patients with RUUTD before treatment. Conclusions It is suggested that urodynamic parameters are significantly improved. Many domains of quality of life were not improved and the reduced quality of life still occurred in NSCD patients with NUB using enterocystoplasty and CISC.